Non-hormonal/copper IUD

Most methods will not cause weight gain. Most people gain weight over time (whether they are using birth control or not), so if you use birth control for a few years, weight gain may not be related to your birth control specifically. The exception to this is the shot. Some people who use the shot will gain some weight. However, the majority of people who use the shot don’t gain much.

Spotting refers to a small amount vaginal bleeding that is unpredictable or irregular and not related to your period. Spotting can be a normal side effect of some birth control methods, especially progestin-only ones like the shot, implant, mini-pill, and hormonal IUDs as well as with low-dose combination birth control pills. When birth control causes spotting, it isn’t dangerous and generally doesn’t make you lose that much blood, even though it might seem like it.

It shouldn’t. You may be a little bit sore immediately after insertion, but ultimately no. If your partner can feel the strings during sex, talk to a health care provider, they can trim the strings.

IUDs are safe for most people with a uterus, and copper toxicity is super rare. That said, it can happen, especially in people with Wilson’s Disease, a rare genetic condition (about 1 in every 30,000 to 40,000 people have it) that affects your body’s ability to process copper. Given how low the daily dose of copper is from the non-hormonal IUD, it is extremely unlikely that someone who does not have Wilson’s Disease would experience copper toxicity.

There are positive and negative things to say about every method. And everyone’s different—so what you experience may not be the same as what someone else experiences. And what side effects are “worth it” to you might be different than for someone else.

You can start by thinking about what’s most important to you about your method. Is your top priority using the method that will be the most effective at preventing pregnancy? Something easy to use? Something that makes your period lighter? Something that you can stop and start without seeing a provider? There are birth control options for all of these. It’s also common to try more than one birth control option before finding one that works for you, so don’t settle if your current option isn’t working.

Most people who use hormonal birth control—combination pill, patch, ring, implant, shot, and hormonal IUDs—will have less painful periods than those who don’t. This is because these methods of birth control make the lining of the uterus thinner. There’s less tissue in the uterus to shed (that’s what happens when you have your period), so periods are lighter. One special note on the implant and the shot: for some people, these methods cause more days of spotting or bleeding in between periods, but periods become lighter and less painful overall.

Using a method of birth control with estrogen, like the combination pill, patch, and ring, increases your risk of forming a blood clot, but if you have no history of stroke, blood clots, or heart attack, and your family members have never experienced a blood clot, the risk is still quite low. If you have a history of these medical conditions, you have a higher risk of forming a new blood clot already so adding birth control with estrogen to the mix increases that risk and isn’t recommended.

Progestin-only methods like the implant, mini-pill, shot, and IUDs don’t increase your risk. If you’re worried about blood clots, we recommend talking to a health care provider about which birth control options are the safest for you.

If you have a sexually transmitted infection (STI) at the time an IUD is placed in the uterus, there is at a higher risk of getting pelvic inflammatory disease (PID). This is why health care providers often check an STI test at the time they place the IUD (you don’t need to have the results before placing the IUD as long as there are no obvious signs of infection when they place the IUD). Having an STI is more likely if you are under age 26, have a new sexual partner, or have multiple partners—because all these groups are at higher risk of having an STI.

The 20 days after having an IUD inserted, you are past the highest risk time for developing PID from an STI you didn’t know you had during IUD insertion. After that time, PID happens at the same rate for people using IUDs as for those using other methods of birth control (other than condoms).

It can be complicated to tell exactly how hormonal birth control affects mood, but you’re the only one who truly knows how you feel. Everyone reacts to birth control differently, so if you feel your birth control might be contributing to depression, talk with your health care provider. It might be a matter of switching methods or deciding whether to avoid hormonal birth control altogether, or you may choose to wait it out since some negative side effects go away with time.

For most people, the risk of blood clots is low when they use the combination pill, the ring, and the patch. But smoking increases this risk. If you are over 35 and smoke 15 or more cigarettes a day, the combination pill, patch, and ring are not safe options for you. If you’re over 35 and you smoke less than 15 cigarettes a day, talk to your provider about whether these birth control methods are safe options for you.

If you have high blood pressure, methods with estrogen—the combination pill, the ring, and the patch—may make your blood pressure even higher, increasing the risk of a heart attack or stroke. Fortunately, there are lots of highly effective birth control options that are safe and estrogen-free like the progestin-only pill, all types of IUD, the implant, and the shot. Talk to a health care provider about your blood pressure and what birth control is an option for you.

The IUD shouldn’t hurt your partner. The IUD strings can bother you or your partner while having sex, but most people can’t even feel the strings. If your partner can feel the strings, and that bothers them, your health care provider might be able to trim them (but they can’t make them any longer). Plus, they usually soften over time, so you could try waiting it out.